by Michael Melgar, MD on March 12th, 2014

How many of us have been in this situation? Its a beautiful June day and you're sitting in church while a happy couple is taking their vows. The groomsmen are lined up on one side and the bridesmaids on the other when one of the bridesmaids begins to wobble. Only seconds later her knees buckle and in an eyeblink she slumps to the floor. Across town a police officer is in his doctors office for a physical. The nurse comes in to the room. She preps his arm to draw some blood, inserts the needle, and "THUNK". She looks up to see him slumped against the wall his glazed eyes staring at the ceiling. Later that afternoon a carpenter is framing a house. He swings the hammer but hits his thumb instead of the nail he was aiming for. Its not the first time he's done this but today is different. Nerve cells carry the pain signal up to his brain as usual but this time an overwhelming sense of nausea sweeps over him, he breaks out in a cold sweat, his eyes go black, and down he goes.


by Michael Melgar, MD on March 8th, 2014

Red Yeast Rice Extract is a Chinese medicine which has been promoted as a "natural" treatement for high cholesterol. Proponents of this treatment ( usually not legitimate medical profesisonals) claim that it offers patients a way to lower their cholesterol without the side effects of medication.


Posted on February 8th, 2014

Many people have heard of a Living Will but most have never thought about it for themselves or taken the time to have one prepared. Even fewer have heard of a Health Care Proxy or know what it is. One poll found that among baby boomers less than 36 percent had completed one of these documents. Most in this group report that since they are young and healthy they do not think about or prepare for death. Among younger individuals the number who have completed such documents is even lower.


by Michael Melgar, MD on December 31st, 2013

The USPSTF has come out with a preliminary recommendation in support of low dose chest CT scans to screen for lung cancer in certain high risk individuals. This is an update of an earlier recommendation which concluded that there was insufficient evidence to recommend for or against such screening. More evidence has now come out allowing the USPSTF to update their recommendation. The new recommendation can be viewed here and is currently open for a period of public comment. If formalized and adopted after the public comment period is completed,  CT scans will be given a Grade B recommendation. Under the Affordable Care Act (ACA also known as Obamacare) once a screening test receives a Grade B rating or higher all insurance companies will have to cover this procedure at no cost to their policyholders.


Posted on December 12th, 2013

Many of the people reading this may already be taking a daily aspirin to prevent heart attacks and strokes because they heard it was good idea, but is it a good idea for everyone?  Like many questions without simple answers, the answer to that question is "It depends".


Posted on November 26th, 2013

A study published today in the prestigious New England Journal of Medicine draws a connection between the daily consumption of tree nuts ( not just almonds) and a reduction in overall deaths from all causes.

Nuts are known to be rich in a number of nutrients including unsaturated fats, fiber, vitamins and minerals. Some previous observational studies seemed to show a correlation between nut consumption and reduced cardiovascular disease.3 Previously a randomized control trial showed that patients at high risk for cardiovascular disease who were put on a Mediterranean diet which happens to also include nuts had a significantly lower risk of cardiac events.4 Other studies have shown a connection between nut consumption and a reduction in inflammation, blood sugar and blood pressure as well as some types of cancer.



by Michael Melgar, MD on November 21st, 2013

As most people know, antibiotics are used to kill bacteria in our bodies. Recently products known as probiotics have become popular. For those who don't know what they are, probiotics are meant to promote the growth of bacteria in our body, primarily in our gut. In theory antibiotics are used to kill harmful bacteria and probiotics are meant to promote the growth of good bacteria but is anything ever that simple? We are starting to learn that the answer to that question is a resounding no.


by Michael Melgar, MD on November 18th, 2013

What are the new guidelines?

Last week saw the announcement of new cholesterol treatment guidelines published by the American Heart Association and the American Cardiology Association. Many believe that the new guidelines will result in millions of additional people being put on statin drugs like Lipitor, Zocor, Crestor, and the many generic equivalents. While this may be true the new guidelines also mean that some people who would previously have been put on statins won't need to.


Posted on November 10th, 2013

Scores of people die yearly from diseases that could be treated and cured if only they had a matching bone marrow donor. These deaths occur in children, young adults, mothers, fathers, wives, and husbands. The saddest part is that many of them die even though there is a perfect match 2 states over, down the street, or even next door, but no one knew because they weren't registered.


by Michael Melgar, MD on November 3rd, 2013

It seems like everyone is taking Omega 3 tablets these days doesn't it? Fish Oil capsules and Flax seed oil supplements containing Omega 3's are advertised and sold in every health food store and pharmacy. Common wisdom is that these supplements are good for everything from preventing heart disease to lubricating joints.

Omega 3's became popular when studies showed that people who ate more fish seemed to have lower rates of cardiovascular disease. Scientists knew that some types of fish were high in Omega 3 fatty acids. Because they have some anti-inflammatory effects it was thought that the Omega 3's might explain the link between higher fish intake and lower rates of cardiovascular disease. Omega 3 supplements were also found to lower triglycerides and since high triglycerides ( a type of bad cholesterol) are associated with an increased risk of heart disease this theory was attractive.






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